Despite decades of study on the contribution of growth hormone (GH) to the development of kidney disease, there remains the question of the relative contribution of elevated levels of GH to kidney damage in humans, particularly in diabetic nephropathy occurring in type 1 patients. In this study, we reviewed several publicly available datasets to examine transcription of twelve genes associated with the GH/IGF1 axis in several types of human and rodent kidney diseases. Our analyses revealed downregulation of renal GHR and IGF1 gene expression in several different chronic human kidney diseases, including diabetic nephropathy, with general upregulation of IGFBP6 in the same tissues and diseases. These findings were generally supported by a review of studies in rodent models. In healthy and diseased human kidneys, increased GHR gene expression was associated with increases in glomerular filtration rate (GFR) and decreases in serum creatinine. IGFBP6 gene expression demonstrated the opposite clinical correlation. Our results suggest the kidney may exhibit GH insensitivity due to low GHR gene expression during most chronic kidney diseases.

尽管对生长激素（GH）对肾脏疾病发展的贡献进行了数十年的研究，但仍然存在着GH水平升高对人类肾脏损害的相对贡献的问题，特别是在1型糖尿病患者中。在这项研究中，我们审查了几个公开可用的数据集，以检查与几种人和啮齿类肾脏疾病有关的GH / IGF1轴相关的十二个基因的转录。我们的分析显示，在几种不同的慢性人类肾脏疾病（包括糖尿病性肾病）中，肾脏GHR和IGF1基因表达下调，而在相同组织和疾病中IGFBP6普遍上调。这些发现通常得到对啮齿动物模型研究的支持。在健康和患病的人类肾脏中，GHR基因表达的增加与肾小球滤过率（GFR）的增加和血清肌酐的降低有关。IGFBP6基因表达证明相反的临床相关性。我们的结果表明，在大多数慢性肾脏疾病中，由于GHR基因表达低，肾脏可能表现为GH不敏感。